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Low vitamin D levels can play a role in sudden, unexplained deaths.
Researchers examined 52 postmortem cases of children aged 2 days to 10 years, of whom 17 had vitamin D deficiency (<25 nmol/L); 24 had vitamin D insufficiency (25-49 nmol/L); 10 had suboptimal vitamin D levels (50-79 nmol/L); and 1 had adequate levels (≥80 nmol/L). They took blood samples and radiographs to check for fractures, which were found in 3 infants.
Three children (2 infants and a 3-year-old ) with vitamin D deficiency died of hypocalcemia; all the children had radiologic and histologic evidence of rickets. The 2 infants had cardiomyopathy, and the 3-year-old had had hypocalcemic seizures.
Ten children with vitamin D deficiency (59%) had abnormalities on histologic studies of the growth plate, but only 3 had abnormal radiographs. Eight infants with vitamin D insufficiency (33%) had abnormal growth plate histology but normal radiology. A high proportion of children in all ethnic groups had low vitamin D levels.
Low vitamin D may be a significant risk factor in bone fractures in children and various diseases including infections and asthma, the researchers say. They note that postmortem vitamin D levels, which are stable and easy and inexpensive to measure, might yield valuable insight into sudden, unexplained childhood deaths as well as asthma deaths and fractures in infants.
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